Thinking of getting pregnant? Don’t drink

Fetal alcohol syndrome is the leading cause of mental disability in the Western world

Fetal alcohol syndrome, or FAS, is a collection of mental and physical defects that can occur in an unborn child if the mother consumes alcohol during pregnancy. It’s the leading known cause of mental disability in the Western world, with a prevalence rate of roughly one case per 1,000 live births.

FAS can be devastating. It primarily affects the fetus’ developing central nervous system, in particular the brain, with subsequent cognitive, functional and behavioral disabilities.

The syndrome is preventable in most cases: Women are advised to simply not drink during pregnancy. But that may be easier said than done. Surveys indicate 10 percent to 15 percent of pregnant women say they’ve consumed alcohol recently; up to 30 percent say they’ve had one drink or more at some point during their pregnancy.

Christina Chambers is a professor of pediatrics at UCSD who specializes in the study and prevention of FAS and other birth defects. With January designated as National Birth Defects Prevention Month, we asked her to assess the current situation.

Q: With no established guidelines for safe alcohol consumption during pregnancy, the current recommendation is no alcohol during pregnancy. Does the same advice apply to women trying to have a baby?

A: Yes, absolutely. In fact, the most common way that a developing baby is exposed to alcohol is in the early weeks of pregnancy before many women know they are pregnant. I would extend that recommendation one step further: A woman should avoid alcohol if she is planning a pregnancy, if she has the potential to become pregnant even though she might not be planning, and certainly if she is pregnant.

Q: What do you say to women who are surprised by a pregnancy, if they’re already a couple of months along?

A: More than 50 percent of women in the United States do not plan their pregnancies, so the opportunity for this kind of a surprise is great. Here in the Department of Pediatrics at UCSD, we run a statewide counseling service for pregnant women and their health care providers (the California Teratogen Information Service Pregnancy Health Information Line at (800) 532-3749 or

ctispregnancy.org), and among all of the women who call us each year, the most common exposure is to alcohol before the woman knew she was pregnant. We counsel women that if they have not already stopped drinking, it is important to stop as soon as they know they are pregnant, and that discontinuing alcohol use through the remainder of the pregnancy is the best thing for their baby.

Q: FAS can stunt fetal growth and weight, but the main impact is upon brain development. What happens, and how does it manifest itself later on?

A: It is clear from brain images of children with FAS that alcohol disturbs brain growth and structure. It is also clear from developmental testing of children with Fetal Alcohol Spectrum Disorders, or FASD, that they have learning and behavior problems that do not go away as the child grows up. In other words, FASD is a lifelong disability.

Q: Are some women more at risk of having babies with FAS than others?

A: Yes, that seems to be true, as not all heavy-drinking women will have infants who have the full-blown syndrome. Women who are at the highest risk of having an affected child are those who have already had a child with FAS. Women who drink in a binge pattern (four or more drinks at a sitting), who are older, and women who metabolize alcohol differently due to their genes might be at higher risk of having an affected child if they drink during pregnancy. Based on some work we are doing regarding this issue in Eastern Europe, we think women who have less than optimum nutrition may be at higher risk. However, we cannot exactly predict which mother will have an affected child. That’s why the recommendation is for all women to avoid alcohol in pregnancy.